Hannah Poling Court Case – Some Considerations

The words “vaccine” and “autism” hit the news again this weekend with the release of the award to compensate the Poling family for pain, suffering, future care and lost wages for their nine year old daughter, Hannah.

Hannah was developing typically until a regressive episode at 18 months that closely followed the 9 vaccinations she received at a well-baby visit. Further testing revealed that Hannah 1) developed autism and 2) had the metabolic signature of a mitochondrial disorder which may have made her vulnerable to injury from the vaccines themselves or the fever that commonly accompanies vaccines and many childhood illnesses.

Although this case has been long fought, the recent award is renewing questions in the autism community.

How common are mitochondrial disorders?

The field of mitochondrial medicine is relatively young, but growing in importance. The United Mitochondrial Disease Foundation (UMDF), with whom Autism Speaks has partnered in an effort to learn more about mitochondrial disorders and autism, reports “while exact numbers of children and adults suffering from mitochondrial disease are hard to determine because so many people who suffer from mitochondrial disease are frequently misdiagnosed, we now know the disease is approaching the frequency of childhood cancers.” Mitochondrial disorders are more broadly defined and therefore possibly more frequent than frank mitochondrial disease, which is typically defined by identifying a known causative mutation. For more on mitochondrial disease and disorders, please see ‘What is Mitochondrial Disease?‘ on the UMDF website.

Testing for mitochondrial disorders is notoriously difficult in part because the field is young and misdiagnoses are common. However, identifying dysfunctional mitochondria in autism and mitochondrial disorders is an area where Autism Speaks has invested in a High Risk, High Impact grant from Autism Speaks awarded to expert clinicians and researchers investigating mitochondrial disorders at University of California at Irvine and University of California, San Diego. Through research and partnership with the UMDF (read story about our recent joint symposium), we hope to shed more light on “mitochondrial autism,” including how it is identified and how best to treat it.

Are there other reports of mitochondrial disorders and autism?

In 2009, John Shoffner, M.D. reported a study of 28 children with an identified mitochondrial disease and autism, looking at the effect of fevers on regression.

One of our investigators in the aforementioned grant, Robert Naviaux, M.D., Ph.D., has written a detailed commentary for the public on these data.

Should this information change my plans to vaccinate my child?

No. The recent award pertains to a legal decision not a new scientific discoveries— it is news and not new science. Therefore, no new recommendations are warranted.

Several epidemiological studies have explored whether either the MMR vaccine or thimerosal, a preservative previously used in vaccines, are linked to autism, and these studies have not supported a link. However, these studies were not designed to identify effects in a small population of potentially vulnerable children due to rare genetic and/or medical conditions.

We are seeking to understand if vulnerable populations exist, including children with unidentified mitochondrial disorders, and if so, how we identify them early so they can be protected from public health threats in the safest manner possible. For more information please see our vaccine statement and an interview with Dr. Geraldine Dawson, Autism Speaks’ Chief Science Officer, about vaccines and autism.

We recognize that this is a sensitive topic in our community. Please be respectful to the opinions of others and especially to the Poling family who has endured the spotlight for too many years.

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I think the Polings case illustrates how real and frightening regression is.They are an incredibly brave family to see this through. In the past vaccine court lawyers have pressured families to sign a a gag order. I do not know the details of the Poling case but they were brave in sharing their daughter’s struggle with the world. I hope Hannah received the fair and just settlement she so clearly deserves.

There is no way to test for mitochrondrial disorders with 100% certainty.My son has had blood tests, a muscle biopsy and the answers are never definitive. Most ASD kids have a disorder- not the full blown disease. Yet even the disorder makes their immune systems vulnerable.

I family history of autoimmune diseases- especially Parkinsons & thyroid diseases and now I vaccinate 1 at a time w/ months in between. I have done for my affected son’s younger sibling and that is now what all his cousins do. But I wish I knew more how to keep our kids safe.

AS should note that although Hannah’s mother had the same genetic signature for mitochondrial dysfunction, she is asymptomatic and went on to be both a nurse and a lawyer, in addition to an amazing autism mom fighting for her child’s recovery. But for the 9 vaccines given in one day, Hannah might have been able to do the same. The evidence for the connection was so overwhelming that HHS settled the case for upward of $20million. Why is AS so reluctant to acknowledge that although the science of mitochondrial functioning, vaccines and autism is in its infancy, common sense and prudence would seem to dictate that UNTIL the studies are done, it would be more prudent NOT to give infants and toddlers multiple vaccines in a single visit?

I see that Autism Speaks defines “autism” in such a way that anyone with any autistic behaviour has “autism”. This, of course, is not the definition used in the Poling case, nor in the relevant nomenclature of ASDs. She did not have “autism”.

Doubtless for empire-building reasons you misreport the findings in this case. Why you mislead parents in this way, rather than trying to properly explain the issues, is intriguing.

Right, after further investigation, it was dtermined that Hannah had a mito dysfunction and an encephlopathy that manifested as autism.

The question is how many other kids like Hannah are out there that are being given the “autism” label but who actually have an underlying mito problem? How many of our kids are being mislabled “autistic” and not being given proper medical treatment because of it?

The medical community is not making much of an effort to explore underlying medical cause of the “autistic” behaviors they take the behaviors on face value and slap on the autism label when they should be running tests to rule in or out a mito problem. Usually the parents have to push for these tests after their kids are already labeled.

Dr. Insel said on 10-15% of autism cass are genetic, so what’s causing the other 85%? Are these cases due to a mito dysfunction?

I completely agree with Angelique’s post.. it would be prudent(safe) not to give babies multiple vaccines especially those with suspected mito or who have a family history of autoimmune, neurodegenerative or neuropsychiatric disease

So glad that AS is investing funding for furher research into autism and mitochondria. Unfortunately, like much of autism research, AS is looking at a genetic link..”rare genetic and/or medical conditions” when realistically, we are looking at an increased number of autistic chldren who have dysfunctional mitochondria not dysfunctional genes. Epigenetics is a better source of research and vaccines during pregnancy (flu-thimerosal) has all the potential of damaging mitochoindriahttp://onlinelibrary.wiley.com/doi/10.1111/j.1469-8749.2007.00726.x/pdf

Mitochondria are vulnerable to toxins. That is where AS needs to be investigating, especially mercury and thimerosal.

I think it is a good idea for AS, with all of its money, to take a look at mitochondria issues and autism – “Through research and partnership with the UMDF (read story about our recent joint symposium), we hope to shed more light on “mitochondrial autism,” including how it is identified and how best to treat it.

I think though, AS is skirting an issue here- the issue that many, many children with an autism diagnosis have dysfunctional mitochondria. Like immune dysfunction, GI dysfunction, sensory dysfunction, cognitive dysfunction, mitochondria are being shown to not work properly in these children. To continue to investigate genes for any of these dysfunctions is inappropriate, ie – “population of potentially vulnerable children due to rare genetic and/or medical conditions”..

The issue of mercury and especially thimerosal in vaccines, is being ignored and denied, like it is a done issue. Hannah had MANY thimerosal vaccines as many other children did as well. Thimerosal has not been removed – it has been reshuffled around the vaccine recommendations so it is now in a more vulnerable population – fetuses, their mothers, and infancy.

Mitochondria have been around for ever — so why now are we hearing about so many children diagnosed with autism also having dysfunctional mitochondria? Please think long and hard on wasting more years chasing ““mitochondrial autism genes” when so much research is showing mercury causes mitochondria to not function properly.

I agree that mito dysfunction is where research should be directed.. Autism researchers should be collaborating with the mito specialist. Also geneticists like Dr. Mario Capecchi who said if the brains immunity, specifically the microglia, are are not functioning properly then that will manifest as mental illness including OCD, Schizophrenia, Alzheimers, Autism.

We were lucky enough to finally have mito diagnosed in our 14 year old son after many years of trying. His history is nearly identical to Hannah Poling’s. Even at this age, identifying this disorder is making a difference for him. I strongly support AS’s involvement in the umdmf and the researchers who desperately want to help our kids. Identifying mito is looking like it will be a lot easier in the not so distant future, which could be a real game changer on so many levels!

I think it is very discouraging to look at your website and not conclusively tell these parents that giving so many immunizations to these children as being wrong. They don’t even fully develop all of their immunoglobulins until the age of two. Yet we inject them with three vaccines at birth, which is massively destructive to these young children and their immune systems. This is why they are finding live versions of the measles in these children and in their spines. Perhaps you have few researchers for all the contributions given and less than accurate knowledge on the subject. Who knows, this website could be receiving contributions from the CDC or such organizations wrapping up such crucial information. Maybe the website could also research the UK vaccine-autism award for Robert Fletcher. Perhaps it will be the final straw to your websites lack of scrutiny over such important information. At least National Autism Association has told parent to think about the recent discoveries before immunization and discard the ridiculous new study (that the CDC funded)saying that there is still no possible way that vaccines cause autism. Right after the polling award no less. It is sad that you can’t give these parents the information that is available already to the public and even sadder that you are supposed to represent the voicelessness in our children.